Details

Autor(en) / Beteiligte

• Morofuji, Toru
• Inaba, Shinji
• Hitsumoto, Tatsuro
• Hara, Kayo
• Morioka, Hiroe
• Higashi, Haruhiko
• Saito, Makoto
• Ohshima, Kiyotaka
• Ikeda, Shuntaro
• Hamada, Mareomi
• Sumimoto, Takumi

Titel

Abstract 12148: Impact of Multiple Plaque Ruptures and Cavity Area on Intraprocedural Stent Thrombosis: Intravascular Ultrasound Analysis

Ist Teil von

• Circulation (New York, N.Y.), 2015-11, Vol.132 (Suppl_3 Suppl 3), p.A12148-A12148

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2015

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• ObjectivesWe examined characteristics of lesions in cases of intraprocedural stent thrombosis (IPST) using intravascular ultrasound (IVUS).BackgroundIPST is a rare complication occurring during percutaneous coronary intervention (PCI) that leads to poor outcomes. However, factors that contribute to IPST remain largely unknown.MethodsWe retrospectively analyzed 1,504 consecutive stent-implanted lesions in 1,324 patients [326 with ST-segment elevation myocardial infarction (STEMI), 403 with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), and 595 with stable angina]. IVUS characteristics of plaques that led to IPST were compared with those of a matched control (non-IPST) group (n = 15) without evidence of IPST matched by age; gender; lesion location; or STEMI, NSTE-ACS, or stable angina. Positive remodeling was defined as a lesion greater than the mean reference external elastic membrane cross-sectional area. Continuous variables were displayed as median and 1st and 3rd interquartile range.ResultsIPST occurred in 5 (0.4%; 3 with STEMI, 2 with NSTE-ACS) of 1,324 patients during PCI. Plaque burden at the minimum lumen area site was significantly greater in the IPST group than in the non-IPST group (93.0% vs. 87.9%, P = 0.0035). All 5 culprit lesions that led to IPST had ruptured plaques with positive remodeling and attenuation. The maximum cavity area was larger in the IPST group than in the non-IPST group (4.6 [4.3, 6.5] mm2 vs. 0 [0, 1.9] mm2, P = 0.0011), whereas plaque rupture was also observed in 40% of subjects in the non-IPST group. Multiple plaque ruptures in the culprit lesion were far more common in the IPST group (80.0% vs. 6.7%, P = 0.0049).ConclusionMultiple plaque ruptures and a larger cavity area were associated with IPST occurrence. IVUS assessment may help predict the development of IPST during PCI.